<%@ page language="java" import="java.util.*"  import="com.gxuwz.medical.domain.person.*"   pageEncoding="utf-8" %>
<!DOCTYPE html>
<html lang="zh-cn">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=no" />
<meta name="renderer" content="webkit">
<title></title>
<link rel="stylesheet" href="../../css/pintuer.css">
<link rel="stylesheet" href="../../css/admin.css">
<script src="../../js/jquery-1.4.4.min.js"></script>
<script src="../../js/pintuer.js"></script>
<%
String path = request.getContextPath();
String basePath = request.getScheme()+"://"+request.getServerName()+":"+request.getServerPort()+path+"/";
String familycode = request.getParameter("familycode");
familycode = new String(familycode.getBytes("ISO-8859-1"), "UTF-8");
%>

</head>
<body>

<div class="panel admin-panel">
  <div class="panel-head" id="add"><strong><span class="icon-pencil-square-o"></span>添加家庭档案</strong></div>
  <div class="body-content">
    <form method="post" class="form-x" action="<%=path %>/system/PersonServlet?method=add"> 
	
    <div class="form-group">
        <div class="label">
          <label>家庭编号：</label>
        </div>
        <div class="field">
          <input  type="text" class="input w50" value="<%=familycode%>" name="familycode"  disabled="disabled"/>
          <input  type="text" class="input w50" value="<%=familycode%>" name="familycode"  style="display: none"/>
	    </div>
      </div>		
	  
	  <div class="form-group">
        <div class="label">
          <label>姓名：</label>
        </div>
        <div class="field">
          <input type="text" class="input w50" value="" name="fullname" data-validate="required:请输入户主姓名" />
	    </div>
      </div>
      
      <div class="form-group">
        <div class="label">
          <label>身份证号：</label>
        </div>
        <div class="field">
          <input type="text" class="input w50" value="" name="idcard" data-validate="required:请输入户主身份证号"  />
	    </div>
      </div>
      
      <div class="form-group">
        <div class="label">
          <label>与户主关系：</label>
        </div>
        <div class="field">
          <select name="relative" id="relative"  required>
         	<option  value="母子" selected="selected">母子</option>
         	<option  value="母女" selected="selected">母女</option>
         	<option  value="父子" selected="selected">父子</option>
         	<option  value="父女" selected="selected">父女</option>
         	<option  value="配偶" selected="selected">配偶</option>
         	<option  value="祖孙" selected="selected">祖孙</option>
        </select>
	    </div>
      </div>
      

      
      <div class="form-group">
        <div class="label">
          <label>性别：</label>
        </div>
        <div class="field">
        <select name="sex" id="sex" required>
         	<option  value="男">男</option>
            <option  value="女">女</option>
        </select>
	    </div>
      </div>
      
      <div class="form-group">
        <div class="label">
          <label>民族：</label>
        </div>
        <div class="field">
          <select name="nation" id="nation" required>
         	<option  value="汉族">汉族</option>
            <option  value="壮族">壮族</option>
            <option  value="其他少数民族">其他少数民族</option>
        </select>
	    </div>
      </div>
      <div class="form-group">
        <div class="label">
          <label>健康状况：</label>
        </div>
        <div class="field">
          <select name="health" id="health" required>
         	<option  value="健康">健康</option>
            <option  value="残疾">残疾</option>
            <option  value="疾病">疾病</option>
        </select>
	    </div>
      </div>
      <div class="form-group">
        <div class="label">
          <label>文化程度：</label>
        </div>
        <div class="field">
          <select name="culture" id="culture" required>
         	<option  value="小学及以下">小学及以下</option>
            <option  value="初中">初中</option>
            <option  value="高中">高中</option>
            <option  value="大学及以上">大学及以上</option>
        </select>
	    </div>
      </div>
      <div class="form-group">
        <div class="label">
          <label>人员属性：</label>
        </div>
        <div class="field">
          <select name="attribute" id="attribute" required>
         	<option  value="群众">群众</option>
            <option  value="共青团员">共青团员</option>.
            <option  value="中共党员">中共党员</option>
        </select>
	    </div>
      </div>
      
      <div class="form-group">
        <div class="label">
          <label>是否农业人员：</label>
        </div>
        <div class="field">
        <select name="farmer" id="farmer" required>
         	<option  value="是">是</option>
            <option  value="否">否</option>
        </select>
	    </div>
      </div>
      
      <div class="form-group">
        <div class="label">
          <label>婚姻状态：</label>
        </div>
        <div class="field">
        <select name="marry" id="marry" required>
         	<option  value="已婚">已婚</option>
            <option  value="未婚">未婚</option>
        </select>
	    </div>
      </div>
      
      <div class="form-group">
        <div class="label">
          <label>工作单位：</label>
        </div>
        <div class="field">
          <input type="text" class="input w50" value="" name="workunit" data-validate="required:请输入工作单位" />
	    </div>
      </div>
      <div class="form-group">
        <div class="label">
          <label>联系电话：</label>
        </div>
        <div class="field">
          <input type="text" class="input w50" value="" name="tel" data-validate="required:请输入联系电话" />
	    </div>
      </div>  
      <div class="form-group">
        <div class="label">
          <label></label>
        </div>
        <div class="field">
          <button class="button bg-main icon-check-square-o" type="submit"> 提交</button>
        </div>
      </div>
      
    </form>
  </div>
</div>

</body></html>